Articles Posted in Falls & Fractures

Nursing homes and assisted living facilities have become increasingly focused on their bottom line in recent years to the detriment of their elderly patients. A recent piece by the New York Times describes the trend where nursing homes have transitioned from non-profits to corporate behemoths – focused on outsourcing and consolidating to minimize costs, reduce their tax liability, and reduce their liability in lawsuits.

According to the nursing homes, consolidation provides a cost-effective way to deliver care to their elderly residents. Through a complex web of corporate ownership, nursing home businesses can reduce their tax liability. According to these nursing homes, those savings are passed on to the residents.

missing-patient-300x196There are also legal benefits to the owners of these nursing home chains – often coming at the expense of the elderly residents. Whenever a person is injured in a nursing home, a complex web of corporate ownership may help the nursing home avoid liability for the harm it has caused. By siphoning the profits of a nursing home into unrelated corporations, injured victims of elder abuse may not be able to hold their nursing home responsible for their damages. Continue reading

As part of President Trump’s promise to roll-back federal regulations, the Trump administration has announced its intention to scrap a federal rule prohibiting nursing homes from requiring their residents to pursue legal claims through arbitration.

In the simplest terms, arbitration is a catch-all term for a dispute-resolution that, while legally binding, does not utilize the court system. The practice has exploded in popularity in recent decades – especially among larger corporations and nursing homes. These entities prefer arbitration because the costs are generally lower, the dispute resolution process moves much faster than the courts, and parties generally do not have a right to appeal thus providing both parties some finality to their dispwalking-out-300x225ute. Opponents of arbitration say the extra-judicial process favors corporate interests and curtails the rights of victims – from limiting discovery to removing the opportunity to appeal. Further, arbitration also removes the right for a person to have their case heard before a jury, and instead substitutes a so-called “neutral arbitrator.”
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With toothless regulations and ineffective oversight, many nursing homes are still failing the neediest patients. With its budget for overseeing nursing homes slashed in half, the Center for Medicare and Medicaid Services (CMS) has failed to identify failing nursing homes and keep them accountable. As a consequence, some nursing homes are choosing to accept the infrequent fines instead of changing their behavior.

helpCMS is responsible for overseeing all nursing homes that receive benefits from these federal entitlement programs. CMS routinely inspects nursing homes for any violations, if a violation is found, then CMS has two options. First, CMS can put the facility on “special focus” status – reserved for the worst offenders. A nursing home with this designation would be routinely inspected more often and, supposedly, would be punished more severely for any violations. Unfortunately, federal budget cuts have blunted the amount of nursing homes that can be put under “special focus.” Since 2012, the budget for inspecting facilities with this designation has dropped by half. Consequently, despite regulators identifying 435 facilities that warranted this designation, only 88 nursing homes were actually put on the watchlist. Further, once a Continue reading

physical-abuse-300x169A Berkshires caretaker has been charged with elder abuse after an 84-year-old man told hospital staff that his two broken ribs were caused by being “thrown around like a rag doll.” The 52-year-old man, Anthony Marcella II, was arraigned in Central Berkshire District Court on charges of assault and battery on a person over 60 or disabled, witness intimidation, caretaker abuse of an elder, and caretaker abuse of an elder causing serious bodily harm. Marcella has pleaded not-guilty to all charges and was released on a bail.

On May 22 or 23, Marcella was allegedly “rough” when picking up the elderly victim (whose name is not provided) after he fell down. According to court documents, Marcella squeezed him in an aggressive manner and proceeded to throw him around “like a rag doll.” The elderly victim suffered two broken ribs as a result of his caretaker’s abusive treatment. Continue reading

On Christmas morning, a certified nursing assistant (CNA) at Woodbriar Health Care in Wilmington, Massachusetts improperly placed a resident in a mechanical lift when transferring her from bed to wheelchair, causing the resident to slip out of the lift and fall, breaking both her legs. The CNA attempted the transfer alone in violation of an important safety rule related to mechanical lifts.

The resident, Mary Meuse, was visited by her youngest daughter on Christmas and told by a staff member X-rays showed no broken bones. As a retired nurse who once cared for the elderly, she did not want to be hospitalized during the holiday. However, the next morning she received a phone call saying her mother was in a lot of pain and needed to be taken to the hospital immediately; the family learned of her injuries upon arrival. Continue reading

On June 2, 2016, two nurses were indicted after being caught on video surveillance ignoring an injured patient at Peninsula Nursing and Rehabilitation Center.  The incident occurred in October 2015. A 51 year old disabled male patient fell in the hallway at the facility, injuring his head and jaw.

Nurses Funmilola Taiwo and Esohe Agbonkpolor can be seen on video ignoring the patient for over 10 minutes as the patient crawled on the floor in agony. After several minutes of watching, Certified Nurse’s Aide Emmanuel Ufot was seen dragging the patient by his arm into his room. 25 minutes later, the patient is seen crawling back into the hallway bleeding profusely from his head and jaw injury while Taiwo and Agbonkpolor stood by watching. Ufot is then seen dragging the patient to his room for a second time by the collar of his gown, twisting it around the patient’s neck. Continue reading

The Nursing Home Data Compendium for 2015 was published March 25, 2016 and showed the percentage of nursing homes with deficiency-free surveys is increasing; this data was collected by the Centers for Medicare & Medicaid Services (CMS). The Compendium includes data on nursing home characteristics, survey results and resident information which was gathered through the CASPER database for survey and certification information, population data from the U.S. Bureau of the Census, and the Minimum Data Set. Data based on nursing home surveys from 2005 -2008 found the likelihood of a nursing home receiving at least one health deficiency increased during that period, but reversed after that time.

Five years later, the percentage of nursing homes without deficiencies increased from 8.8% in 2009 to 10.2% in 2014. There has also been a decrease in the amount of surveys finding substandard quality of care from 4.4% in 2008 to 3.2% in 2014.  The compendium also includes a list of the most frequently cited health deficiencies found on surveys from 2005 to 2014. The top deficiencies were storing and cooking food in a safe and clean way, ensuring the facility is free of accident hazards, providing adequate supervision to prevent accidents, providing necessary care to improve resident well-being and having a program that investigates and controls the spread of infections. Continue reading

Holiday Manor Care Center, a nursing home in California, was fined $100,000 as a result of a resident’s death at the facility. The facility was found to have several deficiencies in the way the staff cared for the patient who had a known risk for falls.

The resident was admitted to the facility in August 2014 with diagnoses of confusion, impaired vision, and unstable balance.  She required assistance when walking. On September 8, 2014, the resident attempted to get out of bed on her own without supervision and fell.  A staff member noticed her on the ground and documented the fall.  The notation indicates she was found on the floor moaning with a bump on the right side of her head and a blueish discoloration.  Nine days later the resident died; she suffered a hemorrhage in the brain and the cause of death was blunt force head trauma. Continue reading

Woodbriar Health Center of Wilmington, Massachusetts faces up to $100,000 in fines following the death of a resident that resulted from a fall on Christmas day of 2015. The nursing home has been accused several times of poor care by the state and families of residents. An 83 year old resident, Mary Meuse, was dropped from a mechanical lift that caused her to break both her legs and led to her death 2 days later. The staff at Woodbriar did not notify Meuse’s family for 24 hours although they were aware of her condition at the time of incident. The nursing home is now facing fines of $250 to $3,000 a day in the wake of Meuse’s death; if the fines begin from December 25, 2015, the facility could face up to $100,000. Continue reading

The shift change is one of the most crucial times of day at a hospital or nursing home.  At its best, it is the time when nurses from the outgoing shift and the incoming shift communicate with each other to ensure they stay on the same page with respect to the patient’s needs and any changes in needs or behavior.   At its worst, it either does not happen at all or when it happens, the appropriate information is not exchanged, which can result in errors and oversights in care. The traditional shift change consisted of nurses conferring in the hallway outside of patients rooms or at the nurse’s station and in some instances, writing up a medical report for the next nurse to read; these methods can result in important information to be left out. Hospitals in Washington are implementing a new method of shift change in order to prevent these occurrences, called bedside shift reports.

bedside reporting

Studies have shown that bedside shift reports make patients feel safe, included, and satisfied. During bedside shift reports, both nurses meet with the patient to handover information from the previous shift. This method helps nurses to communicate better with one another, as well as the patient and the patient’s family. In addition, this method also helps to prevent falls and other injuries. Beverly Johnson, CEO of the Institute for Patient and Family Centered Care in Bethesda, Maryland stated this method is a simple way to ensure that accurate information is passed on and that both nurses understand the care plan for each patient. Continue reading

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